Individual provider Active NPI

Jennifer L. Robertshaw, M.D.

  • Family Medicine Physician
  • Lititz, PA
National Provider Identifier
1619314838
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD458212 Issued in PA
Practice address
300 W Lemon St
Lititz, PA 17543-2311
Phone
(171) 544-8696
Fax
(717) 544-8697
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD458212 PA Primary

Addresses

Primary practice location

300 W Lemon St
Lititz, PA 17543-2311

Mailing address

300 W Lemon St
Lititz, PA 17543-2311
Phone (171) 544-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817000979 PA Practitioner - Family Practice 2062736341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Aug 15, 2016 Accepting new patients
Lancaster General Medical Group Family Medicine CurrentSince Aug 15, 2016 Accepting new patients
Lancaster General Medical Group Current Accepting new patients

Locations

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

562 W 2nd Ave
Lititz, PA 17543
Phone (717) 626-2167

51 Peters Rd
Ste 201
Lititz, PA 17543
Phone (717) 544-6260

1159 River Rd
#F
Marietta, PA 17547
Phone (717) 426-1131

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1619314838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W LEMON ST",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175432311",
            "telephone_number": "171-544-8696",
            "fax_number": "717-544-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W LEMON ST",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175432311",
            "telephone_number": "171-544-8696",
            "fax_number": "717-544-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSHAW",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD458212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

Verify at the official NPI Registry.